Wed, Dec 3, 2008

It is December and Patrick is lying on the bed in a pool of sweat. Today he played basketball after school with some of the older students. He put on quite a performance, at least initially: sinking long shots, drives to the basket, behind the back passes. He is trying desperately to earn some street cred with the kids. But by the end of the game, his white t-shirt was wringing-wet, his face lost all color, and his eyes had a drawn look about them. He admitted to me later that he started to dry heave in the last minutes of the game. White boy can jump, just not for long.

Today after our Creole lesson, we met Patrick Villier at CONASPEH. He hopped in the car with us and we went on a hunt for a near-by lab so that I could straighten out the miscommunication I discovered Monday and learn more about the system. My first surprise was that the lab was not at all close. In fact, the one we drove to was in the city center. I’m sure that there are other labs closer to CONASPEH, but Patrick wanted to take me to one that would have any test I needed.

The lab was on a side street in a busy part of town. When we arrived, one of the teachers from the school was waiting for us, an envelope in hand. He had seen me last week in consultation, and today handed me the letter which held a stapled sheet of all his test results that he dutifully obtained, printed in an organized, easy to interpret fashion. I even could decipher the French notations. A Santa Clause on the sidewalk with a bag full of presents couldn’t have made me happier than that piece of paper. Immediately it told me two things: 1. that there WAS a lab in town that understood my English/Medical jargon, and that 2. at least ONE person was able to get there and get the diagnostic help. He was only one, but he was one. I felt a huge leap of hope surge in my heart. Good day.

We climbed the concrete stairs to the second floor where a woman was sitting at a desk, thumbing through paperwork. We introduced ourselves and asked about the services they provided. Although she couldn’t give me an extensive list of tests offered, she answered our inquires directly and gave me her number to call if I wanted to refer someone there. Over the phone I could ask her about specific tests and costs to the patient I was sending to help me cater to my work-up plan. Contact. Connection. A start.

Then we went to a near-by medical supply store and got a list of everything they had available: clinic supplies, medications, and the necessities to start your own lab. Although I didn’t understand everything on the list, it was good to see what was available as well as the cost for each item. Our dream of a future lab and fully-functioning clinic seemed a bit more possible as I looked down at all the things we could find near by. Great Day.

We were called back to the school a little prematurely. A fight had broke out in our absence, the teachers were overwhelmed and needed help. Getting back, most of the ruckus had died down, but I had a tearful teenage patient waiting for me with a bloodied eye-brow. Madam Fano and I busied ourselves patching up the superficial cut, offering more reassurance than emergency medicine.

While the wound care supplies were out, I retrieved a tiny little patient for follow-up care from one of the first-grade classes. I poked my head in, and asked for the “little girl with a burn.” My brave little patient marched to the front of the class, took my hand, and led me to the clinic. Her mother had approached me yesterday asking me to take a look at her leg. On it was a giant blister, the length of her calf, ugly and oozing. My heart started to pound, my mind racing. Worst case-scenarios came to mind, and panic that I wasn’t sure where I could take her if my suspicions were strengthened at all. I didn’t understand what the mother was telling me about “how this happened.” But familiar with the new “blan” doctor, she kept repeating quietly one word. I dug in my bag for my dictionary and flipped through the pages. Burn. The little girl had been burned. I then understood that a hot pan that had slipped off the stove had burned her. Diagnosis. Relief.

So I met the brave little girl yesterday afternoon. She was clearly a tough bird as her legs wore the dusty evidence of play. Her mother informed me that she cried every time she tried to clean it. But the little girl sat bravely, letting me wash her wound gently, cleaning the skin around it and dressing it safely. Today, the bandage was as clean as could be expected from her home life, and she bravely let me take off the dressings and re-clean. The skin is healing well and there are no signs of infection. I even got a smile from my courageous little patient.

The end of the day was spent watching Patrick’s pick-up basketball game with the students from the school. The activity drew a crowd as many students lingered to watch, to laugh and cheer at the game. I had a group of 2nd grade boys vying for my attention, fascinated by my camera and eager to be young photographers themselves. They assisted me in taking pictures of each other, their friends, and now I have a great collage of some of the faces that make up the school. I was also pretty impressed at their skill behind the lens. I was amused at how carefully they handled the camera, being sure to turn it off after taking pictures and gently handing it back to me. One little boy asked me how many cameras I had. Was it seven? No, only one. But this isn’t the first time we’ve been asked that. Our white skin brings with it the assumption that not only do we have everything, but we have 7 of everything. Although a little exaggerated, its not far from the truth.

So now Patrick lies cooling off on the bed. I have a pile of work to do on the computer, hoping to start a medical record system, type up a lab order form, and design a public health lecture in Creole for Sunday’s radio show. I feel happy. I feel hopeful. I’d like to think there is a lot we can do if I just keep my sense of humor, learn a new type of patience, and continue to delight in the personalities that surround us.